<!DOCTYPE html> 
<html> 
	<head> 
	<title>Page Title</title> 
	
	<meta name="viewport" content="width=device-width, initial-scale=1"> 

	<link rel="stylesheet" href="http://code.jquery.com/mobile/1.0/jquery.mobile-1.0.min.css" />
	<script type="text/javascript" src="http://code.jquery.com/jquery-1.6.4.min.js"></script>
	<script type="text/javascript" src="http://code.jquery.com/mobile/1.0/jquery.mobile-1.0.min.js"></script>
</head> 

<body> 
<div data-role="page"> 
	<div data-role="header">
		<h1>Test Header</h1>
	</div>
	 
	<div data-role="content">
	<form>
		<h2>Dati quotazione</h2>
		<ul data-role="listview"  data-inset="true">
		<li>
			<label for="contract" class="select">Tipo di contratto:</label>
			<select name="contract" id="contract">
				<option value="leasing">Leasing</option>
				<option value="renting">Renting</option>
				<option value="financement">Finanziamento</option>
			</select>
		</li>
		<li>
			<label for="duration" class="select">Durata contratto:</label>
			<select name="duration" id="duration">
				<option value="12">12</option>
				<option value="13">13</option>
				<option value="14">14</option>
				<option value="15">15</option>
				<option value="16">16</option>
				<option value="17">17</option>
			</select>
		</li>
		<li>
			<label for="amount">Imponibile:</label>
			<input type="text" name="amount" id="amount">
		</li>
		</ul>
		
		<h2>Dati cliente</h2>
		<ul data-role="listview"  data-inset="true">
		<li>
			<label for="customerType" class="select">Tipologia cliente:</label>
			<select name="customerType" id="customerType">
				<option value="freelance">Libero professionista</option>
				<option value="association">Associazione</option>
				<option value="company">Societ&agrave;</option>
			</select>
		</li>
		</ul>
		
		<h2>Assicurazione scil</h2>
		<ul data-role="listview"  data-inset="true">
		<li>
			<label for="productType" class="select">Tipologia cliente:</label>
			<select name="productType" id="productType">
				<option value="fixed">Fisso</option>
				<option value="mobile">Mobile</option>
			</select>
		</li>
		<li>
			<label>All risk 5 anni</label>
			<input type="checkbox" name="insurance" id="insurance" />
			<label for="insurance">All risk 5 anni</label>
		</li>
		</ul>
		
	</form>
	</div>
	 
	<div data-role="footer">
		<h1>Test Footer</h1>
	</div> 
</div> 
</body>
</html>